Bronkopulmoner Displaziye Güncel Yaklaşım

Yenidoğan bakım kalitesinin artması çok küçük prematüre bebeklerin yaşatılmasına olanak sağlamış olmakla birlikte bu bebeklerde “Yeni Bronkopulmoner Displazi” (BPD) olarak tanımlanan klinik, radyolojik ve histopatolojik bulguları daha hafif seyirli olan BPD nin yeni bir şekli ortaya çıkmıştır. Yeni BPD şekli, esas olarak akciğer gelişiminde duraksama ve pulmoner fonksiyonların bozulması ile ilişkilidir. Akciğer gelişiminin kanaliküler ve sakküler fazında doğan prematüre yenidoğanlarda çeşitli risk faktörlerinin etkisiyle alveol ve damar gelişimi sekteye uğramakta böylece alveolar ve kapiller hipoplazi ortaya çıkmaktadır. Surfaktan yetersizliği, yenidoğanın ventilasyonu, oksijen tedavisi, reaktif oksijen ürünleri, akciğer ödemi, fetal ve neonatal infeksiyonlar ve akciğer damar gelişiminde bozulma ile bazı antenatal etmenler akciğer hasarlanmasından sorumlu tutulmaktadır. Bu yazıda prematüre yenidoğanlardaki akciğer hasar mekanizmaları, yeni BPD tanımı, klasik BPD tablosundan farklılıkları, BPD den korunmaya yönelik güncel yaklaşımlar incelenmiştir.

Anahtar Kelimeler:

Bronkopulmoner displazi, yenidoğan, prematürite

CURRENT APPROACH TO BRONCHOPULMONARY DYSPLASIA

Improvements in antenatal and neonatal care have resulted in an increase in the survival of very preterm infants, whereas new form of Bronchopulmonary displasia (BPD) that has mild clinical course, radiological, and histopathological findings has occurred in these babies.. This new form of BPD is mainly related with a disruption of lung organogenesis and impaired pulmonary function. In premature infants born at the intersection of the canalicular and saccular phases of lung development, alveolar and capiller development are inhibited following exposure to the noxious effects of different risk factors. As a result, alveolar and capiller hypoplasia occur in these premature babies. These risk factors include surfactant deficiency, neonatal ventilation, oxygen therapy, reactive oxygen species, lung oedema, fetal and neonatal infections, disruption of vasculogenesis, and some antenatal factors that dysregulate subsequent lung development. In this article, mechanisms of lung injury in the preterm infants, the definition of new BPD, the difference between ‘‘old’’ and ‘’new’’ BPD, and the current approaches to prevent BPD have been reviewed

Keywords:

Bronchopulmonary dysplasia, newborn, prematurity,

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